Symptoms of Hormonal Imbalance in Women, & What to Write Down

The symptoms of hormonal imbalance women describe most often are periods that change, PMS that takes out a chunk of every month, fatigue that sleep does not fix, skin and hair that shift, low libido, hot flushes, mood that swings on a monthly pattern, and brain fog. Any of them can have an ordinary explanation and any of them can have a diagnosable one, so they are worth taking to your doctor.

The part that is harder to find is why so many of them arrive at the same point every month, and what to have written down before you sit in the appointment.

The things you were probably told were normal

This is the question I get asked more than any other, and most of what comes up when you search it is trying to sell you something before it has finished the sentence.

If you are here, something has probably been off for a while. You have maybe mentioned it once or twice and been told it is stress, or your age, or just what periods are like.

I am not a doctor and I cannot tell you what is happening in your body. What I can do is tell you what a lot of women notice, why some of it tracks with the cycle, and which bits are worth raising with your doctor rather than absorbing quietly for another decade.

The most common hormonal imbalance symptoms

These are the things that come up again and again in my inbox. Some are ordinary and some are not.

• •periods that are painful, heavy, irregular, or that stop altogether
• •PMS that takes out a chunk of every month
• •bloating and abdominal pain
• •constipation, or digestion that swings
• •fatigue that sleep does not fix
• •acne, dry skin, or skin that suddenly changes
• •hair thinning, brittle nails
• •low libido
• •weight that shifts without much changing
• •hot flushes, night sweats
• •mood that drops or spikes on a monthly pattern
• •feeling foggy, or like your brain is slower than it was

Somewhere in reading that you may have had the small, unwelcome feeling of being described. Most women do. Being able to tick things off a list on the internet is not the same as knowing what is going on, and the next step is a conversation with someone who can actually test and examine you.

Why hormonal symptoms move with your cycle

Hormones are messengers. They travel around telling organs and tissues what to do, and they shift daily. They also shift with stress, sleep, illness, what you are eating, breastfeeding, pregnancy and the years around menopause.

Here is the piece that changed things for me.

Men run mostly on a twenty four hour rhythm. The circadian one, the sun. Women have that too, and a second rhythm on top of it that runs closer to a month. So the assumption underneath almost all mainstream health advice, that you should eat and train and work roughly the same way every day, was built on a body that does not change much across a month, and then handed to bodies that do.

Most research was done on men. Across a hundred years of biomedical studies, only about fifteen per cent included both sexes. When I found that out, a great deal of my own experience finally made sense, and so did the fact that advice which worked brilliantly for my partner did nothing for me.

So if your energy, appetite and patience are different in week one than in week four, you are not inconsistent. You are cyclical, and almost nobody told you what to do with that. I have written about the four phases and what each one asks for if you want the longer version.

Digestion & hormones are not separate

For years I treated my digestion as one problem and my cycle as another. I would work on one, get somewhere, and lose it again. What I noticed in the end was simpler than any theory: the weeks where my digestion was calm were reliably the weeks where everything else was easier.

When women write to me about hormonal symptoms, digestion is in the picture more often than not. So mention both at the same appointment rather than treating them as unrelated complaints on separate days, and let your doctor be the one to work out what is connected to what.

The things worth asking your doctor about directly

This is the part I would most like you to take from the page.

Several things that produce the symptoms above are properly diagnosable, and some of them matter. Thyroid conditions. PCOS. Endometriosis. Fibroids. Diabetes. Perimenopause. These are not things any blog, guide or supplement should be addressing before a diagnosis, and they are found through examination and blood work rather than through a list on a website.

Ask for the tests. A lot of women stop at the first normal result because they have been made to feel like they are making a fuss.

You are not making a fuss. The World Health Organization puts the average time to an endometriosis diagnosis at four to twelve years, and estimates that up to seventy per cent of women with PCOS worldwide do not know they have it.

Also worth naming: birth control, some medications, chronic stress, undereating, overtraining and poor sleep all move hormones around considerably. Those are worth an honest look before assuming something is broken.

When your results come back normal

Your symptoms paint a picture, and one set of results is not the whole of it. If you are told everything is fine and you do not feel fine, please do not stop there.

It can be the kind of test. There are a lot of different hormone tests and a standard panel is not all of them. It can be the day it was taken, because hormones move across the month and the same result can mean something different depending on when the blood was drawn. Both of those are fair questions to put to your doctor: was this the right test for what I am describing, and was it taken at the right point in my cycle.

It can also be something sitting at the very edge of a range. Iron a little low, or a hormone a little off, is still worth asking about, and the person holding your results is the one who can tell you whether it explains anything.

This is also where I found it useful to get another set of eyes. Working with a naturopath, and having more detailed testing done, gave me a different way of reading the same information, and for me that was the part that changed things. None of that is instead of your doctor. Doctors are the ones who find the serious things, which is exactly why you go and why you go first. But if you have been, and you have your results in your hand, and you still feel like something is off, keep asking until someone can explain it to you.

What actually helped me

What helped me was not a protocol. It was noticing. I started paying attention to where I was in my month, and stopped scheduling my hardest weeks against my body. I ate warmer, heavier food in the second half and lighter food when my energy was climbing, which is the whole idea behind eating for your cycle. I stopped training hard in the days before my period, which I had been doing for years while wondering why I felt awful.

None of that was possible until I started writing things down. Tracking is what turned a vague sense that something was off into a pattern I could actually see, and it is where I would tell anyone to begin, because it costs nothing and you can start this month.

Day of your cycle, energy out of ten, mood, sleep, digestion, skin, anything that stands out. Paper is fine. An app is fine. The point is not the format, it is that after a couple of months you start seeing your own pattern rather than reading about someone else's. How to track your cycle goes through it properly, from one line a day to the detailed version.

Two things happen when you do this. You get much better at planning around yourself. And you walk into your appointment with three months of specific, dated observations instead of "I've just been feeling off", which changes that conversation completely.

If you take it as far as charting your waking temperature, that is the version worth putting in front of someone. A doctor or a naturopath can read a few cycles of temperatures and see things in the shape of it that no description of how you have been feeling will ever give them. That was the point it stopped being a diary for me and started being useful.

It is closer to a working relationship than a plan. It took about three months before I trusted it, and it is still the thing I would recommend first to anyone.

What to bring to the appointment

Written down, on one page, in date order:

• •your cycle lengths for the last three months, counted from the first day of proper bleeding
• •which day of the cycle each symptom turned up, not just that it happened
• •how heavy the bleeding was, in something countable
• •what it stopped you doing: work missed, days in bed, plans cancelled
• •anything that has changed, and roughly when it changed
• •what you are already taking, including contraception and supplements

That is the difference between a doctor hearing "I've been tired" and a doctor seeing the same thing landing on day twenty two, three months running.

If something on this page sounded like you, please do book the appointment. I would much rather you had answers than a reading list.

Questions I get asked about this

What are the most common symptoms of hormonal imbalance in women?

Periods that are painful, heavy, irregular or absent. PMS that takes out a chunk of the month. Fatigue that sleep does not fix, bloating, constipation, acne or skin that changes, hair thinning, low libido, hot flushes, night sweats, mood that moves on a monthly pattern, and brain fog. Any of them can be ordinary and any of them can be worth investigating, which is why the list is a starting point for a conversation rather than an answer.

Can a blood test show a hormonal imbalance?

A blood test shows one day. Hormones move daily and across the month, so when in your cycle the blood was taken changes what the result means. That is worth asking your doctor about directly: whether the timing suited what was being measured, and whether it is worth repeating at a different point.

My tests came back normal but I still feel wrong. What now?

Say exactly that, out loud, at the appointment. Ask what else could be looked at, whether it was the right test for what you are describing, and whether the day it was taken mattered. A normal result rules some things out, it does not rule out everything, and it is not a reason to stop asking. Take your notes in with you: three months of cycle lengths, which day of the cycle each symptom turned up, how heavy the bleeding was and what it stopped you doing. A pattern written down in date order is much harder to set aside than a description of how you felt this week.

What should I write down before a doctor's appointment about my periods?

Your cycle lengths for the last three months, counted from the first day of proper bleeding. Which day of the cycle each symptom turned up. How heavy the bleeding was, in something countable. What it stopped you doing. Anything that has changed and roughly when. What you are already taking, including contraception and supplements.

Can digestion problems be related to hormones?

For a lot of women the two turn up together, and bloating and constipation sit on most symptom lists for both. It is worth raising them in the same appointment rather than as separate complaints on separate days, and worth letting your doctor be the one to work out what is connected to what.

Where to go next

• •Unlock your feminine superpowers at each phase of your hormonal cycle, which goes through the four phases properly
• •How to track your cycle, if the tracking part is where you want to start
• •What to eat in your luteal phase, for the fortnight most of us struggle with
• •My journey, if you want the long version of how I got here
• •My free guide to balancing your hormones, if you would like all of this in one place to keep

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